Using urine sodium tests to adjust water pill doses in chronic heart failure
Tests urine sodium checks to guide water pill doses in outpatients with heart failure.
Plain-language title generated from the registry record
Registry title: Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure
Key facts
- Where
- Vancouver, CanadaSee the site
Where in Canada
- Vancouver General HospitalVancouver, CanadaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Cardiology Research UBC
- Trial code
- NCT07369856
- Record updated
- 27 March 2026
- Original description
Heart failure is a chronic condition that causes congestion and frequent hospitalizations. Diuretic doses are usually adjusted based on clinical judgment without an objective measure of response. This study will test the feasibility of using point-of-care urine sodium measurements to guide up-titration or down-titration of loop diuretics in ambulatory patients with heart failure.Read full original descriptionShow less
Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure (SAND-HF)
Heart failure is a chronic condition that causes congestion and frequent hospitalizations. Diuretic doses are usually adjusted based on clinical judgment without an objective measure of response. This study will test the feasibility of using point-of-care urine sodium measurements to guide up-titration or down-titration of loop diuretics in ambulatory patients with heart failure.
Participants will be assigned to one of three groups based on congestion status. Groups 1 and 2 will be randomized 1:1 to natriuresis-guided therapy or standard care. Group 3 will be observational. The 90-day pilot trial will evaluate feasibility, clinical outcomes, and usability of a urine sodium-guided titration strategy.
Inclusion: Age ≥18 years; Diagnosis of heart failure according to the Universal Definition; Use of loop diuretics; Residing in VCH or PHC regions; Group-specific inclusion:; Group 1: Congestion score ≥5 OR objective congestion; stable furosemide ≥1 week Group 2: NYHA I-II; congestion score <5; no recent HF hospitalization; stable furosemide ≥1 month Group 3: First 100 eligible patients not meeting criteria for Groups 1 or 2.
Exclusion: Renal replacement therapy; eGFR <20 mL/min/1.73m²; High-risk clinical status requiring hospitalization; Inability to consent or perform required urine sampling.